Management of HIV/AIDS and security breach at Pretoria C-Max: briefing by Department

Meeting report

SECURITY AND CONSTITUTIONAL AFFAIRS SELECT COMMITTEE
17 November 2004
MANAGEMENT OF HIV/AIDS AND SECURITY BREACH AT PRETORIA C-MAX: CORRECTIONAL SERVICES BRIEFING

Chairperson: Mr L Mokoena (ANC)

Documents handed out:
Department Report on security breach In Pretoria Close Maximum Security Centre
Department PowerPoint presentation on the management of HIV/AIDS among offenders

SUMMARY
The Gauteng Regional Commissioner of Correctional Services provided the Committee with a report on the security breach at C-Max Prison, Pretoria, on 7 November 2004. He also provided a general presentation on security in correctional facilities, highlighting the integrity of Department employees as a major concern. Then the national Department presented on the management of HIV/AIDS in prisons.

The Committee was very concerned about the deaths in C-Max, and directed the Department to do everything in its power to prevent a recurrence. Members welcomed the Department's efforts in dealing with HIV/AIDS in prisons, but asked searching questions about the effects of overcrowding and understaffed facilities, on the prevalence rate.

The Committee passed the President's Resolution on the payment of judges without discussion, as they were under pressure to pass this before Parliament went into recess.

MINUTES

Resolution on judges' salaries
The Chairperson asked the Committee if the resolution on the payment for judges could be passed, as the Committee was under pressure to pass the resolution before Parliament went into recess. Mr Le Roux (DA, Eastern Cape) expressed his concern at passing the resolution without a proper briefing, but agreed that it could be passed. The Chairperson noted Mr Le Roux's concerns. Mr Z Ntuli (ANC, KwaZulu-Natal) thought the resolution had already been discussed, and Mr S Shiceka (ANC, Gauteng) questioned whether a briefing would have any effect. The Chairperson said that the resolution was the initiative of the President, and that the Committee should pass it. Mr A Moseki (ANC, North West) proposed passing the resolution, which was seconded by Ms P Hollander (ANC, Northern Cape).

Security breach at the Pretoria C-Max Prison
Mr Siyabulela Mlombile (Regional Commissioner: Gauteng) briefed the Committee on the breach of security that occurred on 7 November in Pretoria's Closed Maximum (C-Max) Prison, which had resulted in the death of four people. Mr Mlombile said that the facility housed 211 sentenced inmates and 43 non-sentenced inmates. The facility also contained 19 inmates, who were not in C-Max, but were considered low risk. These inmates helped to maintain the kitchen services. The facility currently employed 133 Department of Correctional Services (Department) employees, but actually had 152 posts. The difference was due to resignations and transfers.

The actual breach of security occurred when five inmates tried to hold hostage officials who were on duty in that section of the prison in an attempt to escape. The inmates were armed with a loaded pistol. The late Mr S Gomba (Head of Pretoria C Max) and the late Mr A Ndinisa (Acting Pretoria Area Co-ordinator for Corrections) were at the facility at the time of the event. The two senior officials refused to obey the instructions of the inmates and tried to disarm them instead. The armed inmate fired the shots that took the lives of both officials. Thereafter, it dawned on the inmates that they were not going to escape as planned. A disagreement arose between the five inmates, with two refusing to associate themselves with the shooting.

The remaining three inmates decided to commit suicide, as their sentences were very long, but they were only left with two rounds of ammunition. Two of them put their heads together and asked to be shot, hoping that both of them would be killed with one bullet. As it happened only one inmate died, while the other only suffered a minor wound on the cheek. The gunman shot himself and died. Thus, four people were killed in the incident: the two officials, and one inmate murdered by his fellow inmate, who then died at his own hands.

Mr Mlombile said the South African Police Service (SAPS) had requested that the Department take a backseat in the investigation. Mr Mlombile said the SAPS were making good progress in their investigation that was illustrated by the arrest of a C-Max official. The investigation was continuing.

Mr Mlombile moved on to general security matters. After a similar incident in June, some changes in the security measures at C-Max had been made. This included making C-Max a 'bagless society', in other words, no parcels were allowed. The searching of staff was also increased. According to Mr Mlombile, the biggest security weakness was the profile of the employees. The personnel had not been replaced after the incident in June. After the recent security breach, one of the immediate changes to the security system was a complete change in the personnel manning the entry points to the facility. This function was now fulfilled by the emergency support team of the Department who do not work at C-Max. They had already caught another culprit who tried to smuggle a cellular phone into the facility. Mr Mlombile said more security measures would be taken at C-Max.

Mr Mlombile said they were concerned by the event, but that they had developed a clear security system based on Minimum Security Standards. He said that the challenge faced by the Department was the lack of synchronisation of the security measures. They had identified five pillars upholding their security system. These were: personnel security measures, physical security measures, technological security measures, information security management and procedural security measures. The major weakness was that the individual security measures were not being co-ordinated.

The most important issue was the quality and integrity of the personnel. For many years, the Department had not functioned as a professional security institution. This meant that the recruitment process had not ensured that no criminal elements were employed. Furthermore, employees had not been subjected to regular screening to identify criminal activities. The support services to personnel were also inadequate.

The Chairperson allowed Mr Dennis Bloem (Chairperson of the Correctional Services Portfolio Committee) to make a statement. Mr Bloem said that the incident was very painful and that he was very happy with the presentation and the steps that would be taken. He also said that it was a very sensitive issue and that he hoped that the Committee would pay a visit to the C-Max prison. He said they were dealing with very dangerous people who had no respect for human life. He said that Department staff were human and could give in to temptation, because of the prisoners. He said that corruption had to be addressed.

Discussion
Mr Le Roux (DA, Eastern Cape) asked if C Max was understaffed and if it was overcrowded. In a similar vain, Ms Leo (DA, Northern Cape) wanted to know why the facility had twenty employees less than its compliment. Mr Ntuli (ANC, KwaZulu-Natal) also wanted reasons why so many people had been transferred without being replaced. Mr Mlombile replied that he did not consider C Max to be understaffed, and that there was no overcrowding. He elaborated that C Max was a very specific type of facility as it held only certain types of prisoners. It was a very small prison. He also said that there had been many transfers from C Max prison. The number of 152 employees was an ideal, which did not necessarily have to be met. Funding was a problem, but there was no staff shortage at C Max.

Mr Shiceka (ANC, Gauteng) asked how long Mr Mlombile had been in the service of the Department, as he seemed to grasp the issues that needed to be attended to. Mr Mlombile answered that he had been in the service of the Department since April 2002. His grasp of what needed to be done came from preparation. He also had an intelligence and security background. Mr Shiceka also asked how many similar incidents there had been in last five years. Mr Mlombile said the incidents in June and November were the only ones. Mr Shiceka also asked what the systemic weaknesses of their security measures were. Mr Mlombile replied that it was important to understand that security needed a holistic approach. He mentioned corruption and the difficulty of getting equipment fixed and their inability to buy equipment directly as it had to be purchased by the Department of Public Works. He also mentioned the limited effectiveness of unsophisticated equipment.

Mr Shiceka complained that he had read more about the incident in the media than from the meeting, and said he should have been better informed. Mr Mlombile replied that the media was more informed because of the SAPS. He had not given the media more information than the Committee.

The Chairperson said that the Committee would visit C Max and that they would interact vigorously with the Department, as the situation was very worrying.

Management of HIV/AIDS in correctional facilities
Ms Jabu Sishuba, Department Chief Deputy Commissioner: Development and Care, reported that the Department's management of HIV/AIDS was aligned to the draft White Paper and to the Correctional Services Act. Development and implementation were based on the National Department of Health's guidelines. South Africa was facing many challenges with regards to HIV/AIDS, and correctional facilities, as a microcosm of society, were reflecting these challenges. The provision of health education, maintaining confidentiality and health standards in already overcrowded correctional facilities added to these challenges.

The Department's mandate was derived from the Constitution's commitment to human dignity, and the United Nations' minimum rules for the treatment of prisoners. The Correctional Services Act and the draft White Paper also guided them in this regard.

The Department realised that HIV/AIDS management was a crucial issue. It had therefore elevated its sub-directorate into a fully-fledged directorate. In April 2004, a Director for HIV/AIDS was appointed. The goal of the programme was to ensure that all HIV-infected offenders in the care of the Department received the necessary prevention, treatment, care and support services. It was also a goal to reduce the impact of HIV/AIDS on the Department staff.

Their objectives were to develop and co-ordinate capacity building programmes, to develop and co-ordinate prevention, treatment, care and support programmes for offenders; conduct research on AIDS-related issues; forge partnerships with other related government institutions, NGOs, the private sector and international donor agencies; and to monitor and evaluate programmes for offenders.

On the issue of donor funding, Ms Sishuba said that it had been used for training of offenders and personnel as educators which was a very important aspect of prevention. Donor funding was also used for the training of healthcare workers and the procurement of educational videos. Donor funds would also make it possible to appoint six co-ordinators on a contract basis.

Prevention programmes included awareness-raising sessions by staff and NGOs, condom promotion campaigns, the prevention of mother to child transmission, as well as the procurement and distribution of educational videos.

Ms Sishuba said that in terms of care and support services, they provided therapeutic counselling. The Department's nurses, psychologists and social workers conducted this. The establishment of support groups was also encouraged. They also facilitated the placement of the terminally ill on medical parole, or placement in a Hospice if the offender did not have any relatives who could care for him/her.

The Department had fully qualified nurses who handled the treatment of offenders. Doctors, who were doing sessional work were also available in the facilities. Opportunistic diseases were treated. The Department had developed an action plan to ensure access to antiretrovirals, as their facilities had not qualified as dispensaries for these drugs.

Ms Sishuba told the Committee that the Department was conducting a HIV prevalence survey. They could compel people to disclose their status, but they encourage the inmates to take part in the survey. The survey had samples for the staff and offenders. It would be conducted over the next eleven months. It will be an anonymous survey which would produce unique results. The Department of Health would assist, and a standing committee overseeing the survey had already been established.

Ms Sishuba said that capacity building was very important for prevention. This was done through training and workshops. Master peer educators were trained, as were healthcare workers. Partnerships had also been forged, as the problem of HIV/AIDS could not be dealt with alone. Therefore, external role-players assisted the Department in capacity building, care and support, treatment, counselling and life skills.

Ms Sishuba said the role of the Department's personnel was to serve as a nodal point for information dissemination. They also participated in creating awareness and encouraging healthy behaviour. Furthermore, they would create a caring and supportive environment, advocating non-discriminatory and stigmatising attitudes.

Ms Sishuba highlighted some of their achievements. The directorate had been established. Specific instruments had been developed, and several master trainers were trained. Furthermore, a task team had been established, and several donors had been approached.

Several challenges faced the Department's fight against HIV/AIDS. The numbers of infected offenders were increasing, as was the number of multi-drug resistant TB cases. The pandemic had had a severe impact on the Department's resources. The need for funds was thus on the increase. There was an increasing need for 24-hour in-patient facilities, which was a problem because the correctional facilities had been designed for security purposes, and were therefore not necessarily conducive to this kind of treatment. Personnel ran an increased risk of exposure to the virus. The lack of accreditation to dispense antiretrovirals was also hampering the Department. A big challenge was the stigmatisation facing many of the infected.

Discussion
Ms Hollander was worried about the Department's policy of sending terminally ill inmates to Hospices, but towards the end of the presentation palliative care was mentioned. She wanted to know how Ms Sishuba correlated the two, and if it was necessary to have a care unit for the terminally ill. She was also concerned about the administration of drugs. She asked if the people administrating the drugs were properly trained to do so.

In reply to her questions it was said that in-patient facilities were not only for HIV/AIDS patients. Hospices existed only in Gauteng and were only used when a person was terminally ill and there were no relatives to care for the person. The Hospices volunteer to look after the patients. There was a need for further care units. The nurses administrating the drugs were registered and fully trained to administer the drugs.

Ms Hollander also said that a lot had been done for the treatment of patients, but she wanted to know what had been done about the spiritual side of the illness. Ms Sishuba answered that spiritual treatment was provided through the Correctional Services' own chaplains. They also had social workers, councillors and psychologists. If a person wanted his/her own minister, it would be facilitated.

Mr Shiceka mentioned that a new law pertaining to traditional practices of medicine was passed recently. He asked if the Department had positioned themselves to accept traditional medicines, and if they had a policy allowing traditional medicine for the treatment of HIV/AIDS. In a reply, it was explained that the new law did not provide much guidance on how alternative medicines should be handled. The Department was still waiting for a set of regulations from the Department of Health. There was a security problem with regards to the issue of traditional healers and the verification of the medicine. Mr Shiceka said people would have the choice to use traditional medicine. He said that the Act would provide for the registration of traditional practitioners. He urged the Department not to be caught napping on security measures when traditional medicines were allowed. Ms Sishuba said that traditional medicine were not used in the past because of the security risk, but if it became law, they would have address the issue, as many of the inmates believed in traditional healers. They would create measures to ensure that what entered the facilities was purely medical in nature.

Mr Shiceka also asked how prison conditions affected HIV infections. He said that the conditions in prisons were different from that of society, and that one could therefore not say it was a microcosm of society. As an example, he mentioned that in some cases four men had to share a bed. He also used Limpopo province as an example, explaining that the high temperatures found in this province lead to a depressing environment. He wanted to know if these conditions accelerated the illness, and what happened once a sick person had been identified. Mr Shiceka was told that overcrowding was a big problem and there was no guarantee that rape was not taking place in correctional facilities. This problem was addressed by separating the vulnerable from the hardened criminals. There was also a task team addressing the issue of overcrowding. They were aware that the conditions were adding to the problem. Once a sick person was identified, he/she was taken to the prison hospital, or transferred to the nearest public medical facility if a prison hospital was not available. HIV positive inmates were not separated from HIV negative inmates, apart from instances when it was required for medical purposes.

Mr Shiceka asked Ms Sishuba if they had conducted any scientific research on the effects of the conditions in prisons. He urged the Department to do research of this nature, as well as research on the effects of gangsterism on the spread of HIV. Ms Sishuba said that they had not researched the issues. She agreed that it was very important to do a study of the nature that Mr Shiceka proposed.

Mr Le Roux asked how big the problem of HIV/AIDS was in the Department. The size of the problem would be determined by the prevalence survey. Mr Le Roux said that the prevalence survey would provide a good idea of the size of the problem, but he still wondered what it was at the moment.

Mr Moseki asked if the members of the support groups received adequate support. He also enquired if children were also victims of the disease. Ms Sishuba said that the children in their care were infants who were with their mothers. She did not have any knowledge on the current status of children, as their numbers were small and they left the facilities as soon as they were old enough to leave their mother and be placed in a place of safekeeping. The number of children fluctuated between 200 and 250.

The Chairperson asked Ms Sishuba to provide more information on the prevalence survey. Ms Sishuba said that it was a process that included an action plan and a communication strategy. They wanted to know how prevalent HIV/AIDS was in correctional facilities.

The Chairperson said that stigmatisation of HIV positive people was a big problem. Every Department encouraged people to disclose their status, but he was concerned about what happened to these people thereafter. He said it was a big problem and he did not know how it could be handled. The Department shared the Chairperson's sentiments on the issue of stigmatisation and disclosure.

The meeting was adjourned.